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PubMed1995

The ultrastructure, kinetics and intralobular distribution of apoptotic hepatocytes after portal branch ligation with special reference to their relationship to necrotic hepatocytes.

Apoptosis was originally defined as shrinkage necrosis, as a distinct mode of cellular death from coagulative necrosis in the rat liver lobes after portal branch ligation. To reveal the functional role of the apoptosis of hepatocytes in the volume reduction and recovery of normal hepatic architecture in portal-deprived liver lobes, we ligated the portal vein branch supplying the left and median liver lobes in Wistar rats. The liver lobes were perfusion-fixed with glutaraldehyde solution via the proximal site of the ligated portion of the portal vein on Days 1, 2, 4, 7 and 14 after operation and examined light and electron microscopically. On Day 2 after ligation, massive necrosis of hepatocytes occurred in the central to intermediate zones of the liver lobule, and apoptotic hepatocytes were observed in the boundary region between necrotic and normal areas. Such necrotic area-associated apoptosis of hepatocytes was most frequent on Day 2, declining thereafter. The sequential changes of the cell organelles in apoptotic hepatocytes were distinct from those in necrotic hepatocytes. On Day 7, when necrotic areas had almost disappeared the apoptosis of hepatocytes occurred mostly between intact hepatocytes in the "combined hepatic cell cords" which included no obvious sinusoidal lumen between hepatic cell cords. Such necrotic area-nonassociated apoptosis began to increase in frequency on Day 4, reached a peak on Day 7 and was gone by Day 14, when normal hepatic architecture was recovered. The present study suggests that both necrotic area-associated and non-associated apoptosis of hepatocytes may be induced by mild ischemia and contribute in part to the volume reduction of ligated liver lobes. It further reveals that the necrotic area-non-associated apoptosis of hepatocytes plays a role in reconstructing the architecture of hepatic cell cords after necrotic hepatocytes have undergone dissolution in the liver lobule.

Animals↗
PubMedDate not supplied

Thoracic duct ligation and pericardectomy for treatment of idiopathic chylothorax.

Chylothorax is a devastating disease, and the success rates from either medical or surgical management are less than satisfactory. In some animals with chylothorax, a thickening of the pericardium occurs that is associated with chronic irritation induced by chyle. We hypothesized that pericardial thickening would lead to increased right-sided venous pressures and that abnormal venous pressures would act to impede the drainage of chyle via lymphaticovenous communications after thoracic duct (TD) ligation. We also hypothesized that serosanguineous effusions that occurred after TD ligation could effectively be treated or prevented by pericardectomy in affected animals. TD ligation plus pericardectomy was performed in 17 animals, and pericardectomy alone was performed in an additional 3 animals that presented during a 5.5-year period to the Texas A&M University (College Station, TX). Nineteen animals presented for an evaluation of idiopathic chylothorax (9 dogs and 10 cats), and 1 dog presented for serosanguineous pleural fluid after TD ligation that had been performed elsewhere. Echocardiography was normal in all animals, except for a subjectively thickened pericardium in 7 cats and 6 dogs. Clinical signs of pleural fluid accumulation resolved in 10 of 10 dogs and in 8 of 10 cats after surgery. The overall success rate for the surgical treatment of chylothorax (ie, the resolution of pleural fluid accumulation) in this study was 90% (100% in dogs and 80% in cats). These data suggest that TD ligation in conjunction with pericardectomy has a favorable outcome in animals with idiopathic chylothorax.

Animals↗
PubMedDate not supplied

Endoscopic sphenopalatine artery ligation is an effective method of treatment for posterior epistaxis.

Transantral ligation of the internal maxillary artery is the most widely used surgical technique for control of intractable epistaxis. Although this technique is highly efficacious, significant complications may occur, including oroantral fistula, damage to the infraorbital nerve, and recurrent bleeding. An endoscopic transnasal approach for ligation of the terminal branch of the internal maxillary artery, the sphenopalatine artery, provides an alternative to transantral ligation. We have used endoscopic ligation of the sphenopalatine artery to treat 38 patients requiring surgical therapy for epistaxis. These cases were retrospectively reviewed to analyze the efficacy and morbidity of our technique. Five patients (13%) had significant recurrence of their epistaxis, of whom two required further surgical intervention. There were no major complications in this series. There were some minor sequelae including nasal crusting (34%) and paresthesia of the palate and nose (13%). The median hospital stay was 3 days (range 1 to 10). Endoscopic transnasal sphenopalatine artery ligation seems to be a safe and effective technique for management of posterior epistaxis.

Aged↗
PubMedDate not supplied

Cholesteatoma induction. Consequences of external auditory canal ligation in gerbils, cats, hamsters, guinea pigs, mice and rats.

Surgical ligation of the external auditory canals of Mongolian gerbils produces aural cholesteatomas that are similar to spontaneous gerbilline cholesteatomas. These experimental cholesteatomas expand rapidly, medially displacing the tympanic membrane and eroding bone. Less than 2 months after ligation, half these cholesteatomas are in contact with the bony prominence of the cochlea. Ligation-induced formation of cholesteatomas may be unique to the gerbil. Keratin deposits are produced by similar ligations of the external auditory canals of cats, guinea pigs, hamsters, mice, and rats. However, in these animals there is no medial displacement of the tympanic membrane, no cholesteatoma formation, and no bone erosion. Cholesteatomas were not seen in cats, guinea pigs, hamsters, mice, and rats even after post-ligation intervals of 6 to 36 months.

Animals↗
PubMedDate not supplied

Effects of ligation and irradiation on the submaxillary glands in rats.

Rat submaxillary glands were exposed to excretory duct ligation, high-energy electron irradiation, or a combination of both. Ligation was done on the left excretory ducts, while 24 Gy irradiation was given within 8 days in three divided doses of 8 Gy. In the combined insults, the excretory ducts (one duct per rat) were first ligated, followed by 24 Gy irradiation. The effects were analysed by morphological methods. Ligation of excretory ducts caused morphological disorganization of the gland parenchyma, with resultant disappearance of secretory granules of serous cells, shrinkage of mucous cells, dilation of ducts, pronounced fibrosis and infiltration of inflammatory cells. When irradiated, some serous cells disappeared, leaving empty fibrosed spaces, while mucous cells showed no consequential radio-damage. The combined treatment of ligation of excretory ducts and irradiation caused extensive morphologic evidence of irreversible damage, i.e. no serous cells remained, disfigured and very shrunk mucous cells extremely dilated ducts, infiltration of leukocytes and fibrotic changes of the glands.

Animals↗
PubMed1995

Effects of cecal ligation and colostomy on motility of the rectum, ileum, and cecum in turkeys.

Motilities of the rectum, ileum, and ceca were examined in surgically prepared turkeys by using strain gauge transducers implanted on these sites after cecal ligation or colostomy. All birds were provided ad libitum access to feed and water throughout the study. Cecal ligation increased the frequency of small anti-peristaltic contractions in the proximal (P < .01) and distal (P < .05) rectum and the frequency of defecations (P < .05) compared with intact controls. Cecal ligation decreased the frequency of single contractions in the proximal ileum (P < .05) and that of all contractions in the distal ileum (P < .05), and ligation (P < .01) and colostomy (P < .05) increased the frequency of single contractions in the distal site. However, major and minor cecal contractions were not affected by colostomy in the proximal and distal cecum. The results suggest that the effects on contractile activities of the hindgut must be considered when interpreting responses to cecal ligation and colostomy.

Animals↗
PubMed2006

A pilot randomized control study to evaluate endoscopic resection using a ligation device for rectal carcinoid tumors.

AIM: Rectal carcinoid tumors smaller than 10 mm can be resected with local excision using endoscopy. In order to remove rectal carcinoid tumors completely, we evaluated endoscopic mucosal resection with a ligation device in this pilot control randomized study. METHODS: Fifteen patients were diagnosed with rectal carcinoid tumor (less than 10 mm) in our hospital from 1993 to 2002. There were 9 males and 6 females, with a mean age 61.5 years (range, 34-77 years). The patients had no complaints of carcinoid syndrome symptoms. Fifteen patients were randomly divided into 2 groups: 7 carcinoid tumors were treated by conventional endoscopic resection, and 8 carcinoid tumors were treated by endoscopic resection using a ligation device. RESULTS: All rectal carcinoid tumors were located at the middle to distal rectum. The size of the tumors varied from 3 mm to 10 mm and background characteristics of the patients were not different in the two groups. The rate of complete removal of carcinoid tumors using a ligation device (100%, 8/8) was significantly higher than that of conventional endoscopic resection (57.1%, 4/7). The three patients had tumor involvement of deep margin, for which additional treatment was performed. No complications occurred during or after endoscopic resection using a ligation device. All patients in the both groups were alive during the 3-year observation period. CONCLUSION: Endoscopic resection using a ligation device is a useful and safe method for resection of small rectal carcinoid tumors.

Adult↗
PubMed2003

A new technique of combined endoscopic sclerotherapy and ligation for variceal bleeding.

AIM: To develop a technique of combined endoscopic sclerotherapy and ligation (ESL) in which both techniques of endoscopic sclerotherapy (ES) and endoscopic variceal ligation (EVL) can be optimally used. METHODS: ESL was performed in 10 patients (age 46.4+/-7.9; 9 males, 1 female) with cirrhosis of liver using sclerotherapy needle and Speedband, Superview multiple band ligater (Boston Scientific, Microvasive, Watertown, MA). A single band was placed 5-10 cm proximal to the gastro-esophageal junction over each varix from proximal to distal margin, followed by intravariceal injection of 1.5 % ethoxysclerol (4 ml each) 2 to 3 cm proximal to the gastroesophageal junction on the ligated varices distal to deployed band. EVL was then performed at the injection site. Similarly other varices were also injected and ligated from distal to proximally. In the subsequent sessions, ES alone was performed to sclerose small varices at the gastroesophageal junction. RESULTS: ESL was successfully performed in all patients. A median of 3 (ESL 1, ES 2) sessions (ranged 1-4) were required to eradicate the varices in 9 (90 %) of 10 patients. Recurrence of varices without bleed was seen in 1 patient during a mean follow-up of 10.3 months (ranged 6-15). Two patients died of liver failure. None died of variceal bleeding. None of the patients had procedure related complications. CONCLUSION: ESL may be useful in the fast eradication of esophageal varices. However, randomised controlled trials are required to find out its relative efficacy and impact on variceal recurrence in comparison to ES or EVL.

Adult↗
PubMedDate not supplied

Studies on hyperthermia combined with arterial blockade for treatment of tumors: (Part I) effectiveness of hyperthermia combined with arterial ligation.

Arterial ligation was combined with hyperthermia in rabbits with VX2 tumors implanted in the leg. For seven days after arterial ligation, blood flow was decreased and the pH was low in both normal muscle and tumor tissue. The temperature of normal muscle and tumor tissue increased faster and reached a higher level on heating immediately after ligation than without ligation. The antitumor effect of hyperthermia was stronger immediately after ligation than two or seven days afterwards. However, damage to normal muscle was severe with this combination therapy, so a better method of therapeutic arterial blockade is needed.

Animals↗
PubMed1999

Dihydropyrimidine dehydrogenase activity and fluorouracil pharmacokinetics with liver damage induced by bile duct ligation in rats.

Hepatic metabolism is the main determinant in the pharmacokinetics of 5-fluorouracil (5-FU). Its disposition might be affected with liver dysfunction. In the present study, the influence of liver damage induced by bile duct ligation on dihydropyrimidine dehydrogenase (DPD), a rate-limiting enzyme in 5-FU catabolism, CYP2B, and 5-FU pharmacokinetics were compared in male Sprague-Dawley rats. After 3 weeks of the ligation in two different groups of animals for in vitro and pharmacokinetic experiments, significant increases in serum bilirubin level and spleen weight were found in both groups. No significant differences were noted in bilirubin level or spleen weight of the bile duct ligation group between the two experiment groups. In the in vitro experiment, DPD activity and protein levels determined by Western blot analysis in the bile duct ligation group were slightly but significantly greater than those of a sham-operated group, whereas CYP2B activity and protein level were significantly reduced. These findings were supported by mRNA levels of CYP2B and DPD. When 40 mg/kg 5-FU was administered i.v. in the pharmacokinetic experiment, no significant differences in pharmacokinetic parameters were found between the bile duct ligation and sham-operated groups. These results suggested that DPD activity and protein level were maintained and that 5-FU pharmacokinetics was not altered in the presence of liver damage accompanied by a significant reduction in CYP2B activity and protein level, supporting previous clinical studies showing that mild to moderate liver dysfunction does not affect 5-FU disposition.

Animals↗
PubMed1975

[The arterial bed of the spinal cord in newborn infants following segmental artery ligation].

The aim of the investigation was to find out the number of ligated segmental arteries which did not cause neurological spinal complications. The segmental arteries were ligated at different distances from the aorta and in different numbers. A unilateral ligation of 1--8 segmental arteries near their branching from the aorta did not result in alterations of the arterial bed of the spinal cord. A bilateral symmetrical ligation of 4--5 segmental arteries next to aorta caused a poor filling of root vessels. Uni- and bilateral ligations of 3--4 intercostal and lumbar arteries near the aorta and at the level of intervertebral foramens resulted in both root arteries and the anterior spinal artery being not filled with an opaque substance.

Arteries↗
PubMedDate not supplied

[Fat embolism. A new therapeutic approach to ligation of the inferior vena cava].

An analys is made of the frequency of fat-embolism in patients with battle wounds and in those who suffer traumatisms in every day life; it was found in a high percentage in both groups. It is noted that when tye symptom appear little after the traumatism, the percentage of death is higher (85%) than when they appear within 24 to 72 hours later (10-20%). During 5 year, in the Hospital Central Militar de Mexico 12 cases of fat-embolism have been diagnosed. The first ten were handled by the classic method: ventilatory assistance, corticoids, heparin, etc.; having 30% of deaths. The two last ones were treated by ligation of the inferior vena cava; none of the two died and there was a remarkable change in the course of the clinical manifestations. Based on the experience of the group, in more than 120 cases with ligation of the inferior vena cava due to pulmonary thromboembolism; there was a symptomatic paralelism found between the fat-embolia and the repeated venous embolism; and in our opinion we conclude that the progressiveness of the respiratory insufficiency is due to repeated fat-emboly more so than to the convertion of neutral fat into fatty acids through the action of lipasa in various tissues. With this hypothesis the inferior vena cava was ligated in two patients, and the results obtained were the ones mentioned before. It is emphasized that the procedure has a very low risk of death and there are minimum sequels, more in relationship to the previous flebitic state, than to the ligation itself. It is indicated that the corticosteroids, heparin, ventilatory and cardiac assistance be continued, besides elastic bandage, elevation of the pelvic limbs, exercises, etc. It is accepted that two cases cannot be enough to fully demonstrate how good the method is, but the changes of progress of these two cases after the ligation were so notable, that we are able to recommend this method in all those patients with an important fat-embolism. It is indicated that in the laboratory of Experimental Surgery of the H.C.M. experiments are being made to demonstrate what has been obtained clinically.

Accidents, Traffic↗
PubMed2002

Catalytic antisense DNA molecules targeting Egr-1 inhibit neointima formation following permanent ligation of rat common carotid arteries.

Animal models of neointima (NI) formation have proven useful in gaining insights into the mechanisms of restenosis after coronary angioplasty and stenting, but the events at a molecular level remain incompletely understood. Here, we describe a technically straightforward, rat model of NI formation, involving complete ligation of the common carotid artery and demonstrate the importance of the immediate-early gene and zinc finger transcription factor Egr-1 in this process. Acute cessation of common carotid blood flow by vessel ligation, was followed by the expression of Egr-1 in the arterial media within 3 h and NI formation proximal to the point of ligation at 18 days. Local delivery of catalytic oligodeoxynucleotides (ODN) targeting rat Egr-1 mRNA at the time of ligation reduced both Egr-1 expression and NI formation in this model. In contrast, a scrambled version of this ODN had no inhibitory effect. These studies demonstrate for the first time that arterial intimal thickening following artery ligation is critically-dependent on the activation of Egr-1.

Animals↗
PubMed1999

[The influence of nasal blood flow after ligating external carotid artery and its branches in rabbits].

OBJECTIVE: To study the influence of nasal blood flow after ligation of external carotid artery and its branches. METHOD: We ligate different levels of external carotid artery and its branches, and use laser Doppler flowmetry to observe the change of blood flow in nose before and after operation. RESULT: Among the four types of operation ligating different blood vessels to reduce the blood flow of the operating side, the most effective way is to ligate ipsilateral carotid artery and its branches in the same side. CONCLUSION: After ligation of relating blood vessels, the collateral circulation construct very soon, and the founding speed of that is quicker in the early stage.

Animals↗
PubMed1992

[Changes of the insulin and glucagon receptors in bile-duct ligated rats].

The specific bindings of insulin and glucagon to 40000g pellets including hepatic plasma membrane were measured at 1, 2 or 4 weeks after bile-duct ligation or sham operation in rats. At 1 week after operation, insulin bindings were similar in both bile-duct ligated and control rats, however, glucagon binding in bile-duct ligated rats (30.1 +/- 5.99%) was significantly (p less than 0.01) lower than that in control rats (42.8 +/- 8.13%). At 2 and 4 weeks after operation, insulin bindings in bile-duct ligated rats (2 weeks: 35.2 +/- 3.32%, 4 weeks: 32.3 +/- 4.62%) were significantly (p less than 0.05) lower than those in control rats (2 weeks: 39.7 +/- 5.12%, 4 weeks: 38.4 +/- 3.85%). Therefore, glucagon bindings in bile-duct ligated rats (2 weeks: 26.3 +/- 4.32%, 4 weeks: 26.9 +/- 4.06%) were significantly (p less than 0.01) lower than those in control rats (2 weeks: 42.0 +/- 3.95%, 4 weeks: 45.3 +/- 4.29%). Decrease of insulin bindings, however, was less than that of glucagon bindings. Changes of the insulin and glucagon receptors on the hepatic plasma membrane suggested a reason for a disturbance of carbohydrate metabolism in the liver cell with obstructive jaundice.

Animals↗
PubMed2003

[Need for surgical ligation of patent ductus arteriosus among patients treated at the Neonatology Department of the University of Medical Sciences, Poznan, Poland].

OBJECTIVE: Clinical assessment of newborns requiring surgical ligation of patent ductus arteriosus (PDA). MATERIAL AND METHOD: 51 newborns operated on PDA in Department of Neonatology in Poznań in years 2000 and 2001. Newborns were classified for surgical ligation after echocardiographic examination (ACUSON 128 XP/10 or HDI 3500, sector scanhead 5MHz). Following data were analyzed: antenatal steroid therapy, gestational age, birth weight, Apgar score, the reason of respiratory insufficiency after birth, duration of mechanical ventilation and oxygen therapy, incidence of bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH) and deaths. RESULTS: 30 of 51 analyzed patients had very low birth weight (< or = 1000 g). Antenatal steroids were used in 21 cases, 20 newborns were delivered by caesarean section. The status of 22 newborns was assessed after birth as bad (0-3 points in Apgar scale). In 38 newborns respiratory distress syndrome was diagnosed and 32 required surfactant therapy. Surgical ligation of PDA was performed on 19.8 +/- 14.4 day of life in neonates born in our hospital and on 24.3 +/- 11.9 day of life in newborns admitted for ligation from other wards. Surgery of one patient was complicated by pneumothorax. 42 patients required mechanical ventilation before operation. Mean duration of mechanical ventilation was 33.4 +/- 26.9 days. 30 infants developed BPD and 15 infants IVH III or IV degree, 6 infants died. CONCLUSIONS: PDA is a serious clinical problem especially for very low birth weight newborns. Surgical ligation of a PDA, without transportation of a patient, is associated with a low incidence of complications.

Ductus Arteriosus, Patent↗
PubMed2004

Radiofrequency coagulation versus rubber band ligation in early hemorrhoids: pain versus gain.

OBJECTIVE: Band ligation of internal hemorrhoids is a well-established and accepted office procedure. However, there are several reports focusing on problems associated with this technique, which is perceived by many to be risk-free. This randomized study is aimed to compare radiofrequency coagulation and rubber band ligation of hemorrhoids on the parameters of effectiveness and comfort. MATERIAL AND METHODS: Eighty patients of 2nd degree bleeding piles were randomized prospectively for band ligation (44 patients) or radiofrequency coagulation (36 patients) technique. Parameters measured included postoperative discomfort and pain, time taken to return to work, complications accompanying the procedure and recurrence rate. RESULTS: The post defecation pain was more severe with band ligation (p=0.01) and so was rectal tenesmus (p=0.01). The patients from radiofrequency coagulation group resumed their duties early (2 versus 5 days, p=0.05). Recurrence rate was higher in radiofrequency coagulation group. CONCLUSION: Rubber band ligation is associated with significantly higher post treatment pain and discomfort. As against this, radiofrequency coagulation results in significantly less pain and post defecation discomfort. However, chances of recurrence of bleeding and prolapse of hemorrhoids are comparatively higher using radiofrequency coagulation of hemorrhoids.

Adolescent↗
PubMedDate not supplied

The impact of splenectomy or splenic artery ligation on the outcome of a living donor adult liver transplantation using a left lobe graft.

BACKGROUND/AIMS: The aim of this study was to clarify the impact of splenectomy or splenic artery ligation on the outcome in living donor adult liver transplantation (LDALT) using a left lobe graft. METHODOLOGY: Forty-eight LDALT cases using a left lobe graft were enrolled in this study. The patients were classified into two groups: Group A (n=40), in which neither a splenectomy nor a splenic artery ligation was performed, and Group B (n=8), in which a splenectomy (n=6) or a splenic artery ligation (n=2) was performed. Indications for splenectomy were as follows: 1) demonstrating a hypersplenism and/or 2) having splenic aneurysms. RESULTS: None of the patients receiving a splenectomy or a splenic artery ligation experienced any septic complication in this series. The graft-recipient weight ratio in group B tended to be smaller than in group A. In group B, all patients were classified into Child's class C or B. The incidence of esophageal varices in group B was significantly higher than in group A. Moreover, the platelet count and the white blood cell count in group B were significantly lower than in group A. No statistical difference was found in postoperative functional cholestasis and intractable ascites. None of the participants in group B experienced both postoperative hyperbilirubinemia and intractable ascites, which were characterized as a small-for-size graft after LDALT. The patient survival rate in group B seems to be better than in group A. In a majority of the cases the portal pressure as well as the portal vein flow after a splenectomy decreased in comparison to that before the splenectomy. CONCLUSIONS: Splenectomy or splenic artery ligation is considered to be beneficial for improving the outcome in LDALT using a left lobe graft.

Adult↗